In this issue of Pediatrics, Dasgupta-Tsinikas et al present several important issues faced by clinicians in selecting antibiotic therapy for infants and children with urinary tract infection (UTI) based on laboratory-reported culture results. The laboratory report provides the clinician with 2 important pieces of data: the minimum inhibitory concentration (MIC) of each antibiotic tested against the urine isolate and an interpretation of that MIC value, given as susceptible (S), intermediate (I), or resistant (R). The MIC at which an antibiotic/organism pair goes from S to nonsusceptible (that includes I and R), is the “breakpoint,” and differentiates lower MICs for an antibiotic/pathogen pair for which antibiotic treatment should be successful at standard antibiotic doses from higher MICs at which there is an increased risk of microbiologic failure. This reported breakpoint interpretation of the MIC is under the jurisdiction of the United States Food and Drug Administration (FDA) and is generally...

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